Green radiotherapy: AITRO survey on sustainability awareness among Italian radiation therapists

Introduction Sustainability has become a growing priority in healthcare, including radiotherapy. Promoting sustainable practices is crucial to reducing environmental impact, optimizing resource use, and improving departmental efficiency. This study, conducted by the Italian Association of Radiation Therapy and Medical Physics Technologists (AITRO), aimed to explore the culture of sustainability among Italian radiation therapists (RTTs). Methods A nationwide anonymous survey was developed by a focus group of RTTs from AITRO’s to ensure clinical relevance. The 17-question questionnaire, divided into five thematic areas, was distributed during the AITRO National Congress 2024 and via social media for two additional weeks. Data were analyzed using descriptive statistics and non-parametric tests. Results A total of 191 valid responses were collected with median age of 38 years and balanced geographical representation across Italy. Only 14.7 % had attended sustainability-focused training, and 17.8 % had participated in related events. The overall knowledge level on sustainability was moderate (median = 3/5), with 38.2 % reporting limited knowledge. A significant association was found between attending sustainability sessions and higher knowledge scores (p < 0.05). Sustainable initiatives were reported by 41.9 % of respondents, with slightly higher adoption in Northern centers. Barriers to implementation included insufficient training and lack of structured guidance. Conclusions Italian RTTs demonstrate moderate awareness of sustainability, with limited training and heterogeneous adoption of sustainable practices. These findings highlight the need for structured educational programs, enhanced interprofessional awareness, and institutional support. Scientific Association such as AITRO can play a pivotal role in promoting and fostering sustainability policies in radiotherapy.